COOPERSTOWN MEDICAL CENTER (NPI# 1962548214) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962548214 |
| Entity Type | Organization |
| Organization Name | COOPERSTOWN MEDICAL CENTER |
| Other Organization Name | CMC RURAL HEALTH CLINIC |
| Practice Address |
1200 Roberts Ave Ne Cooperstown ND 58425-7101 |
| Practice Telephone | 7017972221 |
| Mailing Telephone | 7017972221 |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2010-07-28 |
| Authorized Official Name | GREGORY A. STOMP (ADMINISTRATOR CEO) |
| Authorized Official Telephone | 7017972221 |
| Is Organization Subpart | Y |
| Parent Organization Name | COOPERSTOWN MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | BLUE CROSS BLUE SHIELD | 4770 | 01 |
| ND | 5000 | 05 |
| Other Name | Type Code |
|---|---|
| CMC Rural Health Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134304231 | Cooperstown Medical Center | Durable Medical Equipment & Medical Supplies | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2008-01-08 |
| 1376635151 | Cooperstown Medical Center | Medicare Defined Swing Bed Unit | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2006-09-29 |
| 1285726067 | Cooperstown Medical Center | Skilled Nursing Facility | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2006-09-29 |
| 1235239229 | Cooperstown Medical Center | General Acute Care Hospital | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2006-09-22 |
| 1548378474 | Cooperstown Medical Center | General Acute Care Hospital | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2006-08-29 |
| Street Address |
1200 ROBERTS AVE NE |
| City | COOPERSTOWN |
| State | ND |
| Zip Code | 58425-7101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851393144 | Brian Twete | Nurse Practitioner | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2005-06-01 |
| 1144500596 | Griggs County Nursing Home | Skilled Nursing Facility | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2011-08-17 |
| 1053645317 | Brooke Leigh Fredrickson | Dietitian, Registered | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2009-09-18 |
| 1134304231 | Cooperstown Medical Center | Durable Medical Equipment & Medical Supplies | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2008-01-08 |
| 1376635151 | Cooperstown Medical Center | Medicare Defined Swing Bed Unit | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2006-09-29 |
| 1285726067 | Cooperstown Medical Center | Skilled Nursing Facility | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2006-09-29 |
| 1184716045 | Agassiz Dental Associates, PC | Dentist | 1200 Roberts Ave Ne, Cooperstown, ND 58425 | 2006-09-29 |
| 1235239229 | Cooperstown Medical Center | General Acute Care Hospital | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2006-09-22 |
| 1770691651 | Norman Leo Berthiaume | Nurse Practitioner | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2006-08-29 |
| 1548378474 | Cooperstown Medical Center | General Acute Care Hospital | 1200 Roberts Ave Ne, Cooperstown, ND 58425-7101 | 2006-08-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932310315 | Outlook Chiropractic | Chiropractor | 605 8th St Nw, Cooperstown, ND 58425 | 2007-05-25 |
| 1972923373 | Cia Gronneberg | Social Worker | 912 Burrel Ave Se, Box 567, Cooperstown, ND 58425-0567 | 2014-04-24 |
| 1235559683 | Griggs County | Public Health or Welfare | 912 Burrel Ave Se, Cooperstown, ND 58425-0567 | 2014-04-24 |
| 1912099870 | Arlo D Neumiller | Dentist | 1200 Roberts Av Ne, Cooperstown, ND 58425-0569 | 2006-09-29 |
| 1821210154 | Leon Donald Paczkowski | Pharmacist | 848 Burrell Ave., Cooperstown, ND 58425-0627 | 2007-05-03 |
| 1558379248 | Pharmacists Associates LLC | Pharmacy | 901 Burrell Ave Se, Cooperstown, ND 58425-0627 | 2006-08-04 |
| 1982814497 | City of Cooperstown | Ambulance | 611 9th St. Ne, Cooperstown, ND 58425-0712 | 2007-05-23 |
| 1396258745 | Rachel Marie Dahl | Pharmacist | 901 Burrel Ave Sw, Cooperstown, ND 58425-0901 | 2017-11-08 |
| 1710473764 | Larissa Ann Haug | Physician Assistant | 1200 Roberts Avenue Ne, Cooperstown, ND 58425-7101 | 2018-07-02 |
| 1992051221 | Essential Chiropractic Pllc | Chiropractor | 402 4th St Sw, Cooperstown, ND 58425-7541 | 2012-07-24 |
| Find all providers in zip 58425 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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| 1023550118 | Northwood Deaconess Health Center | Clinic/Center | 308 Whinery Street, Binford, ND 58416 | 2016-11-07 |
| 1689085797 | Northwood Deaconess Health Center | Clinic/Center | 611 Towner Ave, Larimore, ND 58251 | 2014-05-12 |
| 1043649486 | Jacobson Memorial Hospital Care Center | Clinic/Center | 215 3rd Ave W, Richardton, ND 58652-7109 | 2013-11-06 |
| 1700064599 | Rolla Eye Clinic | Clinic/Center | 118 3rd St. Ne, Rolla, ND 58367-1170 | 2008-02-05 |
| 1891859948 | Nelson County Health System | Clinic/Center | 117 2nd St West, Lakota, ND 58344 | 2006-12-21 |
| 1760570394 | West River Health Services | Clinic/Center | 211 Main Street, Scranton, ND 58653 | 2006-10-10 |
| 1942398508 | West River Health Services | Clinic/Center | 420 Pacific Ave, Mott, ND 58646 | 2006-10-10 |
| 1871691519 | Jacobson Memorial Hospital Care Center | Clinic/Center | 603 East St N, Elgin, ND 58533-7105 | 2006-09-20 |
| Find all providers with the same taxonomy | ||||
| City | COOPERSTOWN |
| Zip Code | 58425 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.